NPIMap

Organization Active NPI

State of New Mexico

Doing business as New Mexico State Veterans Pharmacy

  • Pharmacist
  • Truth Or Consequences, NM
National Provider Identifier
1033135074
Registry record updated Apr 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
CS00021264 Issued in NM
Legal business name
STATE OF NEW MEXICO
Doing business as
New Mexico State Veterans Pharmacy
Practice address
992 S Broadway
Truth Or Consequences, NM 87901
Phone
(575) 894-4200
Fax
(575) 894-4291
NPI assigned
Jul 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Marie R Richter
Title
Administrative Services Director
Phone
(575) 894-4216

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X CS00021264 NM Primary

Addresses

Primary practice location

992 S Broadway
Truth Or Consequences, NM 87901

Mailing address

992 S Broadway
Truth Or Consequences, NM 87901
Phone (575) 894-4200

Other identifiers 2

IdentifierTypeStateIssuer
65755MedicaidNM
3208774OtherNMMEDICARE D

Other names 1

  • New Mexico State Veterans Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Scientific Laboratory Division Nmdoh43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

Organizations that report the same tax identification number in the National Provider Directory.

View all 42

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/04b7d73f-0769-4509-8cd9-c3061dc75979/

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492473600000",
    "number": "1033135074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "992 S BROADWAY",
            "city": "TRUTH OR CONSEQUENCES",
            "state": "NM",
            "postal_code": "87901",
            "telephone_number": "575-894-4200",
            "fax_number": "575-894-4291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "992 S BROADWAY",
            "city": "TRUTH OR CONSEQUENCES",
            "state": "NM",
            "postal_code": "87901",
            "telephone_number": "575-894-4200",
            "fax_number": "575-894-4291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF NEW MEXICO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2017-04-18",
        "status": "A",
        "authorized_official_last_name": "RICHTER",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ADMINISTRATIVE SERVICES DIRECTOR",
        "authorized_official_telephone_number": "575-894-4216"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "NM",
            "license": "CS00021264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65755",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE D",
            "identifier": "3208774",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Mexico State Veterans Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Truth Or Consequences, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.